25 research outputs found

    Achieving consensus on psychosocial and physical rehabilitation management for people living with kidney disease

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    From Crossref journal articles via Jisc Publications RouterHistory: epub 2023-05-19, issued 2023-05-19Article version: AMPublication status: PublishedPelagia Koufaki - ORCID: 0000-0002-1406-3729 https://orcid.org/0000-0002-1406-3729Background People living with chronic kidney disease (CKD) need to be able to live well with their condition. The provision of psychosocial interventions (psychological, psychiatric, and social care) and physical rehabilitation management is variable across England, as well as the rest of the United Kingdom. There is a need for clear recommendations for standards of psychosocial and physical rehabilitation care for people living with CKD, and guidance for the commissioning and measurement of these services. The NHS England Renal Services Transformation Programme (RSTP) supported a programme of work and modified Delphi process to address the management of psychosocial and physical rehabilitation care as part of a larger body of work to formulate a comprehensive commissioning toolkit for renal care services across England. We sought to achieve expert consensus regarding the psychosocial and physical rehabilitation management of people living with CKD in England and the rest of the UK. Method A Delphi consensus method was used to gather and refine expert opinions of senior members of the kidney multi-disciplinary team (MDT) and other key stakeholders in the UK. An agreement was sought on 16 statements reflecting aspects of psychosocial and physical rehabilitation management for people living with CKD. Results Twenty-six expert practitioners and other key stakeholders, including lived experience representatives, participated in the process. The consensus (>80% affirmative votes) amongst the respondents for all 16 statements was high. Nine recommendation statements were discussed and refined further to be included in the final iteration of the ‘Systems’ section of the NHS England RSTP commissioning toolkit. These priority recommendations reflect pragmatic solutions that can be implemented in renal care and include recommendations for a holistic well-being assessment for all people living with CKD who are approaching dialysis, or who are at listing for kidney transplantation, which includes the use of validated measurement tools to assess the need for further intervention in psychosocial and physical rehabilitation management. It is recommended that the scores from these measurement tools be included in the NHS England Renal Data Dashboard. There was also a recommendation for referral as appropriate to NHS Talking therapies, psychology, counselling or psychotherapy, social work or liaison psychiatry for those with identified psychosocial needs. The use of digital resources was recommended to be used in addition to face-to-face care to provide physical rehabilitation, and all healthcare professionals should be educated to recognise psychosocial and physical rehabilitation needs and refer/sign-post people with CKD to appropriate services. Conclusion There was high consensus amongst senior members of the kidney MDT and other key stakeholders, including those with lived experience, in the UK on all aspects of the psychosocial and physical rehabilitation management of people living with CKD. The results of this process will be used by NHS England to inform the ‘Systems’ section of the commissioning toolkit and data dashboard and to inform the National Standards of Care for people living with CKD.inpressinpres

    At the intersection of mind and climate change : integrating inner dimensions of climate change into policymaking and practice

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    Dominant policy approaches have failed to generate action at anywhere near the rate, scale or depth needed to avert climate change and environmental disaster. In particular, they fail to address the need for a fundamental cultural transformation, which involves a collective shift in mindsets (values, beliefs, worldviews and associated inner human capacities). Whilst scholars and practitioners are increasingly calling for more integrative approaches, knowledge on how the link between our mind and the climate crisis can be best addressed in policy responses is still scarce. Our study addresses this gap. Based on a survey and in-depth interviews with high-level policymakers worldwide, we explore how they perceive the intersection of mind and climate change, how it is reflected in current policymaking and how it could be better considered to support transformation. Our findings show, on the one hand, that the mind is perceived as a victim of increasing climate impacts. On the other hand, it is considered a key driver of the crisis, and a barrier to action, to the detriment of both personal and planetary wellbeing. The resultant vicious cycle of mind and climate change is, however, not reflected in mainstream policymaking, which fails to generate more sustainable pathways. At the same time, there are important lessons from other fields (e.g. education, health, the workplace, policy mainstreaming) that provide insights into how to integrate aspects of mind into climate policies. Our results show that systematic integration into policymaking is a key for improving both climate resilience and climate responsiveness across individual, collective, organisational and system levels and indicate the inner human potential and capacities that support related change. We conclude with some policy recommendations and further research that is needed to move from a vicious to a virtuous cycle of mind and climate change that supports personal and planetary wellbeing

    Reconnection: Meeting the Climate Crisis Inside Out

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    Climate change is a physical reality, demanding political and practical solutions. But its inner dimension, overlooked entirely by mainstream approaches, is a human crisis of relationship. This report outlines the relevance of mindfulness and compassion practices in addressing the endemic disconnection from self, others and nature at the root of the climate crisis.We explore the cognitive and emotional foundations of conscious connection and discuss the potential for mindfulness and compassion practices to be developed into powerful enablers of reconnection, fostering both greater resilience and more appropriate responses to global sustainability crises.Written by Jamie Bristow, Rosie Bell and Professor Christine Wamsler (LUCSUS), the report follows a research collaboration between the Mindfulness Initiative and the Lund University Centre for Sustainability Studies, including 25 in-depth interviews with national and transnational politicians and policymakers, and a large-scale consultation with leading experts working on ‘inner’ aspects of the climate crisis. We draw upon the emerging evidence base linking internal transformation to sustainability, and broader academic literature on the prosocial impact of mindfulness and compassion training

    Inner Development Goals: from inner growth to outer change

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    Inner Development Goals (IDG) is a non-profit and open-source initiative for inner development. We research, collect and communicate science-based skills and qualities that help us to live purposeful, sustainable, and productive lives. Supported by a growing community of practitioners, researchers, organisations and governments, IDG seeks to bridge the gap between personal growth and global transformation. In keeping with the spirit of IDG, this article is a testament to co-creation and collaboration, made possible by every member of our organisation, partners, and community

    Somatosensory activations during the observation of touch and a case of vision-touch synaesthesia.

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    In this study, we describe a new form of synaesthesia in which visual perception of touch elicits conscious tactile experiences in the perceiver. We describe a female subject (C) for whom the observation of another person being touched is experienced as tactile stimulation on the equivalent part of C’s own body. Apart from this clearly abnormal synesthetic experience, C is healthy and normal in every other way. In this study, we inves-tigate whether C’s ‘mirrored touch ’ synesthetic experience is caused by overactivity in the neural system that responds to the observation of touch. A functional MRI experiment was designed to investigate the neural system involved in the perception of touch in a group of 12 non-synesthetic control subjects and in C. We investigated neural activity to the observation of touch to a human face or neck compared with the observation of touch to equivalent regions on an object. Furthermore, to investigate the somatosensory topography of the activations during observation of touch, we compared activations when observing a human face or neck being touched with activations when the subjects themselves were touched on their own face or neck. The results demonstrated that the somatosensory cortex was activated in the non-synesthetic subjects by the mere observation of touch and that this activation was somatotopically organized such that observation of touch to the face activated the head area of primary somatosensory cortex, whereas observation of touch to the neck did not. Moreover, in non-synesthetic subjects, the brain’s mirror system—comprising premotor cortex, super

    Interplay of demographics, geography and COVID-19 pandemic responses in the Puget Sound region: The Vashon, Washington Medical Reserve Corps experience

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    Background Rural U.S. communities are at risk from COVID-19 due to advanced age and limited access to acute care. Recognizing this, the Vashon Medical Reserve Corps (VMRC) in King County, Washington, implemented an all-volunteer, community-based COVID-19 response program. This program integrated public engagement, SARS-CoV-2 testing, contact tracing, vaccination, and material community support, and was associated with the lowest cumulative COVID-19 case rate in King County. This study aimed to investigate the contributions of demographics, geography and public health interventions to Vashon’s low COVID-19 rates. Methods This observational cross-sectional study compares cumulative COVID-19 rates and success of public health interventions from February 2020 through November 2021 for Vashon Island with King County (including metropolitan Seattle) and Whidbey Island, located ~50 km north of Vashon. To evaluate the role of demography, we developed multiple linear regression models of COVID-19 rates using metrics of age, race/ethnicity, wealth and educational attainment across 77 King County zip codes. To investigate the role of remote geography we expanded the regression models to include North, Central and South Whidbey, similarly remote island communities with varying demographic features. To evaluate the effectiveness of VMRC’s community-based public health measures, we directly compared Vashon’s success of vaccination and contact tracing with that of King County and South Whidbey, the Whidbey community most similar to Vashon. Results Vashon’s cumulative COVID-19 case rate was 29% that of King County overall (22.2 vs 76.8 cases/K). A multiple linear regression model based on King County demographics found educational attainment to be a major correlate of COVID-19 rates, and Vashon’s cumulative case rate was just 38% of predicted (p Conclusions While the overall magnitude of the pre-Omicron COVID-19 pandemic in rural and urban U.S. communities was similar, we show that island communities in the Puget Sound region were substantially protected from COVID-19 by their geography. We further show that a volunteer community-based COVID-19 response program was highly effective in the Vashon community, augmenting the protective effect of geography. We suggest that Medical Reserve Corps should be an important element of future pandemic planning
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